Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

Leon, Natalie; Schneider, Helen; Daviaud, Emmanuelle

doi:10.1186/1472-6947-12-123

Cited by 179 publications

(222 citation statements)

References 20 publications

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“…This will help to promote project success and is particularly important for planning for scale. The WHO’s MAPS Toolkit (mHealth Assessment and Planning for Scale) [11] provides useful guidance, as does the newly released WHO guide for Planning Digital Health Mobile Interventions [12]. From another perspective, it can be of interest to investigate further the reasons for the success of consumer-oriented based apps like Viber or WhatsApp among clinicians when seeking advice [12,13] in spite of the many issues of privacy and security that they entail.…”

Section: Discussionmentioning

confidence: 99%

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations

Wallis

Hasselberg

Barkman

et al. 2017

Global Health Action

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Background: Diagnostic support for clinicians is a domain of application of mHealth technologies with a slow uptake despite promising opportunities, such as image-based clinical support. The absence of a roadmap for the adoption and implementation of these types of applications is a further obstacle. Objectives: This article provides the groundwork for a roadmap to implement image-based support for clinicians, focusing on how to overcome potential barriers affecting front-line users, the health-care organization and the technical system. Methods: A consensual approach was used during a two-day roundtable meeting gathering a convenience sample of stakeholders (n = 50) from clinical, research, policymaking and business fields and from different countries. A series of sessions was held including small group discussions followed by reports to the plenary. Session moderators synthesized the reports in a number of theme-specific strategies that were presented to the participants again at the end of the meeting for them to determine their individual priority. Results: There were four to seven strategies derived from the thematic sessions. Once reviewed and prioritized by the participants some received greater priorities than others. As an example, of the seven strategies related to the front-line users, three received greater priority: the need for any system to significantly add value to the users; the usability of mHealth apps; and the goodness-of-fit into the work flow. Further, three aspects cut across the themes: ease of integration of the mHealth applications; solid ICT infrastructure and support network; and interoperability. Conclusions: Research and development in image-based diagnostic pave the way to making health care more accessible and more equitable. The successful implementation of those solutions will necessitate a seamless introduction into routines, adequate technical support and significant added value.

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Section: Discussionmentioning

confidence: 99%

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations

Wallis

Hasselberg

Barkman

et al. 2017

Global Health Action

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show abstract

“…Given the complexity of health systems and the need to keep accurate and thorough records of patient data, maintaining patient privacy and integrating with existing health care systems can be extremely challenging from both the regulatory and technological sides [13]. Many pilot projects focus on collecting data as an independent system rather than integrating it with a country’s data collection system, which can be very difficult if there is no electronic medical record and a paper patient file is still used [14].…”

Section: Regulatory Considerationsmentioning

confidence: 99%

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Wallis

Blessing

Dalwai

et al. 2017

Global Health Action

123

121

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While the field represents a wide spectrum of products and services, many aspects of mHealth have great promise within resource-poor settings: there is an extensive range of cheap, widely available tools which can be used at the point of care delivery. However, there are a number of conditions which need to be met if such solutions are to be adequately integrated into existing health systems; we consider these from regulatory, technological and user perspectives. We explore the need for an appropriate legislative and regulatory framework, to avoid ‘work around’ solutions, which threaten patient confidentiality (such as the extensive use of instant messaging services to deliver sensitive clinical information and seek diagnostic and management advice). In addition, we will look at other confidentiality issues such as the need for applications to remove identifiable information (such as photos) from users’ devices. Integration is dependent upon multiple technological factors, and we illustrate these using examples such as products made available specifically for adoption in low- and middle-income countries. Issues such as usability of the application, signal loss, data volume utilization, need to enter passwords, and the availability of automated or in-app context-relevant clinical advice will be discussed. From a user perspective, there are three groups to consider: experts, front-line clinicians, and patients. Each will accept, to different degrees, the use of technology in care – often with cultural or regional variation – and this is central to integration and uptake. For clinicians, ease of integration into daily work flow is critical, as are familiarity and acceptability of other technology in the workplace. Front-line staff tend to work in areas with more challenges around cell phone signal coverage and data availability than ‘back-end’ experts, and the effect of this is discussed.

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“…[33] [34][35][36][37] As shifting health challenges combine with maturing eHealth opportunities, consideration of different solutions, in different proportions, in different settings is required. This constantly changes the nature of eHealth investment decisions.…”

Section: Resultsmentioning

confidence: 99%

Increasing Need for an eHealth Impact Framework for Africa (Preprint)

Broomhead¹,

Mars²,

Scott³

et al. 2018

Preprint

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Background: Efforts by African countries to improve healthcare and citizens' health within challenging resource limitations put considerable pressure on investment decisions. eHealth is believed to have potential to strengthen health systems and is now seen by some entities as a determinant of health, yet its impact is not well estimated in advance or measured after implementation. This is an obstacle to the effective allocation of healthcare resources and limits national and regional abilities to develop eHealth and realise its potential in health systems transformation.

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Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

Cited by 179 publications

References 20 publications

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations

Integrating mHealth at point of care in low- and middle-income settings: the system perspective

Increasing Need for an eHealth Impact Framework for Africa (Preprint)

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